As it stands, healthcare should really be thought of as sick care.

When you interact with the healthcare system, something is already wrong.

You need an antibiotic because you have an infection.

You broke a bone.

You have back pain.

You have something on your skin that looks irregular.

Chest pain, trouble breathing, abdominal pain…

Hospitals, doctors offices, urgent care centers, surgery centers, these are place you go when you are unwell.

But then where do we go to stay well?

Who is responsible for that?

Now it’s messy.

Not only to stay well before we get sick at all, but even after we have been sick.

Patients who get ostomies have a 30% 30-day readmission rate.

Surgeons are great at making ostomies, but then who is responsible once the patient goes home? Should it really fall to the surgeon to ensure the patient does all the right things when they get home?

Can they?

Who keeps us well? Who should keep us well?

We know fundamentally that eating a balanced diet and exercising is going to take care of a significant amount of health problems.

Beyond that, smoking and some other lifestyle changes would likely make us significantly healthier.

But these things require access to a stable job and opportunities for economic improvement. Safe housing. Nutritious food. A strong education system. A public health system that functions.

Who keeps us well? Who should keep us well?

We can’t expect doctors whose training is in healing to shoulder this burden.

Where is the money for private institutions to take on these issues? I am sure no hospitals are racing to keep people from coming into the hospital for knee replacements, heart surgery, or bypass surgery.

So when we talk about healthcare what are we talking about?

And when we talk about fixing a broken system, should we also be talking about creating a second system?

One designed to help keep people healthy?